Objective To compare the advantages and disadvantages between laparoscopic operation and laparotomy in the treatment of Mirizzi syndrome.MethodsThe clinical data of 67 cases with Mirizzi syndrome were analyzed retrospectively from January 2008 to June 2011.Thirty-five cases were treated with laparoscopic operation(laparoscopic operation group),type Ⅰ in 24 cases,type Ⅱ in 11 cases,3 cases with conversion to laparotomy were rejected (type Ⅱ in 8 cases really).Thirty-five cases were treated with laparotomy(laparotomy group),type Ⅰ in 20 cases,type Ⅱ in 15 cases.The operation time,blood loss duringoperation,intake time of food,postoperative complications and hospital stay were compared between two groups.ResultsThe operation time was (53.2 ± 21.5) min,blood loss during operation was (23.2 ± 21.5)ml,intake time of food was 6 h,postoperative complications were with 3 cases (9.4％,3/32),hospital stay was(5.4 ±2.3) d in laparoscopic operation group.The operation time was(98.7 ± 17.2) min,blood loss during operation was ( 113.4 ± 31.6) ml,intake time of food was (46.8 ± 12.4) h,postoperative complications were with 5 cases( 14.3％,5/35 ),hospital stay was ( 11.3 ± 2.7) d in laparotomy group.Except for postoperative complications,there were significant differences in the operation time,blood loss during operation,intake time of food and hospital stay between two groups(P＜0.05).ConclusionsLaparoscopic operation is safe and feasible in treating type Ⅰ and most type Ⅱ Mirizzi syndrome.It has more advantages than laparotomy.

Objective To evaluate a modified liver hanging maneuver(retrohepatic tunnel of the IVC) in patients undergoing hemihepatectomy.Methods Twenty-four patients undergoing hemihepatectomy were divided into two groups:modified liver hanging maneuver group(n=12)and Pringle's maneuver group(n=12).The amount of intraoperative bleeding,operation time,postoperative liver function,liver function recovery and complications were compared between the two groups.Reset All operation were performed successfully and there were no difference in the time of operation etween the two groups.There was a difierence in the amount of mean intraoperative blood loss between the two groups.It was(160±40)ml in liver hanging group and(560±120)ml in Pringle's group(P＜0.01).Liver function recovery measured on postoperative day 3 and day 7 was better in liver hanging groupthan that in Pringle's group(P＜0.01).The volume of postoperative peritoneal serous fluid dranage was significantly less in liver hanging group(P＜0.01).Conclusion The modified liver hanging maneuver is useful for hemihepatectomy.

【Objective】 To study the effect of macrophage mediator 1 (MED1) deficiency on atherosclerosis in female mice. 【Methods】 ApoE knockout (ApoE^-/-), LDLR knockout (LDLR^-/-), MED1^fl/fl, and macrophage MED1 knockout (MED1^△Mac) mice were recruited in the study. Two types of mouse model were constructed:ApoE and macrophage MED1 double knockout (MED1^△Mac/ApoE^-/-) mice and their littermate controls (MED1^fl/fl/ApoE^-/-). ② LDLR knockout (LDLR^-/-) mice receiving bone marrow from MED1^△Mac (MED1^△Mac→LDLR^-/-) or MED1^fl/fl (MED1^fl/fl→LDLR^-/-) mice. Female mice from these two models were fed a Western diet (21% fat and 0.15% cholesterol) for 12 weeks to promote the development of atherosclerosis. Body weight, total cholesterol (TC), and total triglyceride (TG) content in plasma were measured dynamically. After Western diet feeding for 12 weeks, aortic tree and aortic root were collected and hematoxylin-eosin (H&E) and oil red O staining were performed. 【Results】 Plasma TC and TG did not significantly differ between MED1^fl/fl/ApoE^-/- control group and MED1^△Mac/ApoE^-/-experimental group. However, the plaque area in aortic tree and aortic root was significantly increased in MED1^△Mac/ApoE^-/-mice. Moreover, compared with that in MED1^fl/fl→LDLR^-/- control group, the plaque area of aortic tree and aortic root had an increasing trend in MED1^△Mac→LDLR^-/- mice group. 【Conclusion】 MED1 deficiency in macrophages promotes the development of atherosclerosis in female ApoE or LDLR knockout mice.